Designing an effective integrated clinical model

As the shift to risk-sharing and value-based models of care continues, physicians, hospitals and hospital based physician group must put greater focus on better coordination of care and outcomes. They must also be capable of taking on some level of clinical and financial risk. But how do we integrate these different aspects into a single […]
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Simplifying care coordination for high-risk patients

The previous blog post in this series introduced, HealthEast, a Minneapolis health system using data and analytics to drive success in their medical home care management. This post will discuss how the system applied data and analytics to get great results. For their care coordination and reporting needs, HealthEast decided to install Optum One, a […]
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Privacy and security audit preparedness — document, document, document!

When it comes to HIPAA, two of the most troubling events that keep health care executives awake at night are reportable data breaches and failing an audit by the U.S. Department of Health and Human Services Office for Civil Rights (OCR). Even with all the current publicity surrounding privacy and security, many organizations still fail […]
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5 reasons why Medicaid agencies should use cloud-based services

To what degree has your state made the move to cloud-based services? More and more states are successfully implementing data processing and hosting solutions in the cloud. These anything-as-a-service (XaaS) solutions can be more cost-effective and responsive to changing needs. When will your state Medicaid agency get on-board? To help you overcome any concerns, here […]
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Using data and analytics for care management in medical homes

Less than five years ago, a Minneapolis-based health system went all-in to the medical home model, with great results. The HealthEast Care System is the largest health care provider in the East Metro area of Minnesota’s Twin Cities. In addition to its four hospitals, HealthEast runs 14 primary care clinics, a variety of specialty care […]
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Transparency provides competitive edge for health care providers

As high-deductible health plans become increasingly popular, cost may become a primary deciding factor for consumers seeking medical providers. But that doesn’t necessarily mean that consumers want the cheapest price. Instead, they want to spend their dollars wisely by understanding pricing and seeing clear accountability for outcomes. In a word, they want transparency. “The future […]
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Countdown to ICD-10 compliance: Why KPIs and provider relations matter

It seems like we’ve been talking about ICD-10 for a long time now and in fact, we have. There are just a few months separating payers, providers — and even patients — from the changes that will arrive with the October 1, 2015, compliance deadline. The limitations of decades old coding will finally give way […]
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The Power of Real-World Evidence

Next week, May 16 – 20, Optum colleagues, clients, industry peers, global researchers and thought leaders are gathering in Philadelphia at the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) 20th Annual International Meeting. I’m looking forward to convening with our clients, discussing our progress and brainstorming about the new challenges to be tackled. Reflecting […]
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Changing reimbursement models requires changes to physician compensation models – characteristics of value-based compensation Model

My previous blog, “Changing Reimbursement Models Requires Changes to Physician Compensation Models – Fundamental Pillars to Building a Strong Physician Compensation Model,” outlined that there are five pillars that the model should incorporate. Value-based transformation requires incentivizing physicians and the care team on a variety of behaviors that go beyond productivity. Outlined below are a […]
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Welcoming veterans to the workforce? EAP management consultation services can help.

Put yourself in the shoes, for a moment, of the returning military veteran you’ve just hired. The corporate environment feels strange, even foreign. In the military, you followed a clear chain of command. Orders were clear-cut; you knew your mission. When deployed, you formed close bonds with your fellow service men and women. You lived […]
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